Heart rate turbulence (HRT) is a promising marker for risk of mortality after acute

myocardial infarction (AMI). We investigated HRT for risk stratification in high-risk

patients after MI. HRT from 24-hour Holter monitoring in 481 hospitalized patients after

AMI with heart failure and/or diabetes with left ventricular dysfunction before randomization

in the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and

Survival Study (EPHESUS). Over a 1-year follow-up, 55 died, 49 of cardiovascular causes.

HRT onset (TO) and slope (TS) were calculated using previous and cohort-optimized

cutpoints and their independent contribution to risk of cardiovascular death determined.

multivariate analysis (TS and TO normal, TS or TO abnormal, TS and TO abnormal), both

independent predictor of cardiovascular death in a high-risk population after AMI, with a

possibly higher optimal cutpoint for HRT slope than previously reported. © 2009 Elsevier

Inc. (Am J Cardiol 2009;103:1495–1499)